Globally Networked Learning (GNL): Linking Canadian and Danish Nursing Students

1. Globally Networked Learning (GNL): Linking Canadian and Danish Nursing Students May 29, 2018 Jacqueline Limoges PhD RN Kirsten Nielsen PhD RN Lesley MacMaster, MScN RN Randi KontniMScH & E RN

3. Denmark Overview Population 5.7 million people Capital city: Copenhagen Holstebro: 36,000 citizens

4. Background • Calls for education to develop culturally safe nursing care Intercultural learning CASN Standards 50% of students to have an international learning opportunity by 2020

5. Objectives of the Presentation • Examine Globally Networked Learning (GNL) strategies used by a Canadian and Danish BScN program to offer an intercultural learning assignment without the need to leave home. • Discuss the student experience with GNL • Consider how GNL can be implemented on a on a larger scale through discussions with Canadian and Danish nursing faculty presenters.

6. Ethics • Georgian Research Ethics Board Approval • Approval from the Danish and the European General Data Protection Regulation

7. The assignment was created by the Danish and Canadian faculty to align with the course learning objectives and nursing theories orienting the course. • Situated the assignment in a med/surg year two course. • Due dates were collaboratively negotiated given the two different semester systems.

8. Process • Students volunteered • Faculty placed students into groups of four (2 Danish and 2 Canadian) • Students completed the project using the assignment due dates as a guide and also by negotiating with their course schedules. • Students linked using Facebook, Google Docs, Skype and Email.

9. Participants in the research Fall 2017: 1st mini pilot project: (8) 6 students Winter 2018: 2nd pilot project: 16 students 2 Danish & 2 Canadian students/group • Interviews & reflections (to date) • 6 Canadian students & • 4 Danish students Model photos

10. General findings from the students about their experiences with GNL • “I like to do things that are out of the norm” (C02, D01, D03) • “I feel like [participating in GNL] has put me a foot forward in my learning. I am able to say now, I wrote a paper with students in Denmark, I have been through the process, I put the work in” (C02) • “Also the fact that GNL will be noted on my diploma is an advantage. Later on in the programme, I want to study abroad, so this is a kind of preparation” (D01)

11. The Global Reach of the Nursing Community “[Nursing] practice is becoming more and more international as more and more people are coming to Denmark from other countries. Maybe once, you will work as a nurse in another country, so you can always use [what you learned from the assignment]. [Nursing] is practiced across cultures and countries” (D03] ”Indeed, our understanding of nursing has been extended” (D02) “It really starts to bring home that we are a community no matter where you are, and that as nurses, we can always help each other grow. We can always work as nurses and identify things that we can do better. You really start to understand how much nursing is about one big huge family” (C01)

12. Step 1 – Comparing and contrasting the lived experience Learning from the experience of others in a different country reinforces messages about the human experience of health and illness and how nursing can support wellness “Even while I was doing the project, it made me look at my patients differently and … realize that there is a lot more going on than just them now in the hospital” (C05) “It really made me reflect on the way we treat our patients … while much is similar, the way we see the whole patient is a little bit different than in Canada … we focus more on each individual patient” (D01)

13. Step 2: Comparing and contrasting the health system – taking the best from each country… “To them, it just seems normal to have someone at home, but for us, it is more focused on the acute care” (C03) “In Canada, the public coverage depends on your income, age and if you receive social assistance and where in Canada you live. In Denmark, the coverage is the same all over the country … As long as you pay taxes on your income and have a legal residence in Denmark you get this for free” (D02 & D04 from reflection paper) “I can see that Canada is good, but I found Denmark really went forward and they have done more with… handling primary prevention. And it makes me realize how much healthcare can be improved. Learning from other countries can take us in that direction.” (C02)

14. Step 3 – Deciding upon a culturally appropriate nursing strategies that would work in both countries “We agreed that applying the Advanced Practice Clinical Leadership Nurse role for lung cancer patients would help relieve excessive stress, enhance care provided, and give rise to more patient autonomy” (D01 & D03 reflection paper) “In Canada, medication and hospitalization were the only methods she was using to cope with COPD. Whereas in Denmark, the patient was using YouTube, he was doing a diet, exercise, he just had more variety in what he was doing” (C04)

15. Step 4 Reflection – using this knowledge for practice in the future ”Cooperation across the countries was exciting as I didn´t know much of Canada before I got to know the Canadian students” (D02) “making sure that I take those moments to really talk to my patients to see what is going on with them” (C01) “I really like that I was able to make a connection in another part of the world” (C05) “Nurses have a great influence on patients’ health … we have an obligation to support people to live in a healthy way, how we can promote health and prevent diseases” (D01)

16. Learning outcomes and conclusions • The students enjoyed the opportunity to work in a group to enhance their organizational and collaborative writing skills and hone research utilization. • When explaining nursing theory & practice to someone from another country, you need to understand it quite deeply and thus the learning outcome increased. • Students see GNL as a strategy that is accessible and provides an inter-cultural experience. • The time zones and different semester structures were minor challenges to overcome. • Students were enthusiastic about their learning experiences and recommended we continue to offer this opportunity.

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20. Differences in Structure of the Semesters Canada Denmark